Immuno-oncology for surgeons

Abstract

Cancer has traditionally been treated with surgery, cytotoxic chemotherapy and/or radiotherapy. The focus of treatment has been the mutated neoplastic cell. Critical advances in genomic and molecular techniques herald the potential for personalized treatments. Incremental breakthroughs in immunology have translated to a step‐change in care by providing a mechanistic understanding of the immune system and how it may be mobilized to target cancer cells. As a result, clinical trials of immune‐modifying agents have increased at an exponential rate and are revolutionizing cancer care. It is increasingly likely that the surgical oncologist will find themself caring for patients who have had immuno‐oncology therapies as part of their neoadjuvant or adjuvant treatment. This review provides an update on immuno‐oncology for the surgeon, covering the mechanisms of action of the agents in use. Emerging and surgically relevant toxicities are discussed, and available data on combining and sequencing cancer surgery with immuno‐oncology treatments are summarized.

Drug resistance mechanism and reversal strategy in lung cancer immunotherapy

“…In theory, immunotherapy can treat all types of cancer patients. According to clinical experience, preoperative immunotherapy can fight for the chance of surgery, and reduce the recurrence rate after surgery ( Forde et al, 2018 ; Lee et al, 2019 ; Reuss et al, 2020 ). In addition, postoperative immunotherapy can reduce the risk of recurrence after surgery by promoting physical recovery and killing residual tumor cells ( Zhu et al, 2021 ; Chaft et al, 2022 ).…”